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Postpartum Depression

More Than 'Baby Blues'
By Marie Stone
WebMD Feature
Reviewed by Craig H. Kliger, MD

Jan. 1, 2001 -- When David Resnick's wife, Susan, experienced severe postpartum depression after the birth of their second child, the couple's world fell apart. "I went into survival mode," David Resnick says. "I had a wife who was clearly ill, a 4-month-old baby, and a 3-year-old daughter."

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Postpartum Depression

Postpartum depression (PPD) is a complex mix of physical, emotional, and behavioral changes that happen in a woman after giving birth. According to the DSM IV, a manual used to diagnose mental disorders, PPD is a form of major depression that has its onset within four weeks after delivery. The diagnosis of postpartum depression is based not only on the length of time between delivery and onset, but also on the severity of the depression

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To make matters worse, other family crises also loomed. "At the time, my mother was diagnosed with stage IV ovarian cancer, my wife's mom had a bad back, and my sister-in-law who lives down the street just had twins," says David. "There weren't a lot of family members to help us."

An estimated one in 10 new moms experience postpartum depression, or PPD, according to the National Institute of Mental Health. Except for the timing of the illness and the vivid, disturbing thoughts of hurting or killing the baby that some women experience, the symptoms of PPD otherwise mirror those of major depression. Symptoms can include sleep disturbances, fatigue, sadness, loss of interest, appetite changes, weight loss or gain, difficulty concentrating or making decisions, irritability, agitation, feelings of worthlessness, and suicidal thoughts.

As David Resnick soon discovered, information and support for the male partners of women with PPD are slim. A study published in the July/August 1999 issue of The American Journal of Maternal/Child Nursing indicated that the partners of women suffering from PPD often feel overwhelming frustration, fear, anger, resentment, confusion, and isolation. "As a man, it's really hard to deal with all of those emotions," David says.

Getting a diagnosis also can be a problem. Susan Resnick first went to her primary care physician for help, but he missed the diagnosis. "He said I should take a vacation," Susan Resnick says. But the couple knew more was going on than a vacation could cure.

PPD often is confused with the so-called "baby blues," characterized by weepiness, anxiety, irritability, and fatigue that typically end within 10 days of delivery. But unlike the baby blues, PPD can emerge anytime -- even months -- after the delivery and last a year or more if not treated. While doctors speculate that PPD is related to complex physiological changes occurring in the mother's body after her baby's delivery, the exact cause remains unknown.

The Resnicks' experience is not unique, says Sandra Thomas, PhD, director of the doctoral program in nursing at the University of Tennessee, and the researcher whose study was published in the nursing journal. Thomas noted similar stumbling blocks for the eight PPD-affected couples included in her study. They were told by doctors, "Oh, all new moms are tearful. Don't worry about it," she says. Thomas believes the study underscores the need for more PPD preparedness among health professionals.

Wendy Davis, PhD, a psychotherapist and the Oregon and Idaho state coordinator for Postpartum Support International, agrees. Many healthcare professionals lack sufficient training, she says. Davis says PPD was not covered in her own doctoral program 12 years ago. Like many, she had a personal PPD crash course when it flared up after the birth of her first child.

"One of the biggest problems is that these men are so isolated," Thomas tells WebMD. "It was really disturbing to think of how alone these guys were, and how much they struggled and suffered."

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